Anna Louie Sussman’s book, Inconceivable: The Impossibility of Family in an Age of Uncertainty, arrived as Rep. Alexandria Ocasio-Cortez has been documenting her egg freezing journey. | Sarah Rice/Getty Images “From the outset, reproduction is a collaborative venture,” writes Anna Louie Sussman, a journalist who has spent years reporting how people all over the world try, and too often fail, to build the families they want. Her work explores how the collaborators of reproduction keep multiplying: doctors, employers, legislators, insurers, and a fertility industry that increasingly promises not just a baby but a better one. In her new book, Inconceivable: The Impossibility of Family in an Age of Uncertainty, Sussman traces the economic, political, and psychological negotiations that stand between people and the children they say they want. Her reporting challenges the assumption that falling birth rates can be fully explained by metrics like income, marriage and education that demographers tend to focus on. She argues the answers are much more personal and resistant to measurement. I wanted to better understand what Sussman meant by this idea of “impossibility of family” — and how one would even determine that, whether as a prospective parent or as a policymaker. What are the biggest barriers to having kids and how do people tell the difference between what they can’t afford and what they’ve come to believe they need? How much does the media conversation about these issues inform people’s choices? I spoke with her about what Rep. Alexandria Ocasio-Cortez’s egg freezing reveals about women who aren’t running for president, what countries that subsidize fertility treatment tell us about the demand going unmet here, and why she hesitates to say outright that having children is good. Our conversation has been lightly edited and condensed for clarity. You started working on this book seven years ago. What has most surprised you about how the conversation around fertility and family formation has changed in that time? There are some people on the left who have always paid attention to family issues, like Elizabeth Warren with her work on bankruptcy and the “two-income trap,” but I do think we’ve been seeing a lot more movement there, with groups like the Congressional Dads Caucus [in 2023], and care infrastructure ideas like those in the Build Back Better Act. There’s also been all this movement around paid leave in the states, 3-K and pre-K, and attempts for more affordable child care. On the right there’s been the rise of this strange pronatalism and the turn that’s taken with what I’ve wound up calling “kid-maxxing.” Plus this embrace in Silicon Valley and among the super rich with so-called super babies and the really overt embrace of technology to make children on this industrial scale. I also did not expect Roe to be overturned. I would have hoped that would’ve come with a lot more attention on the right to support for mothers and children, but that really hasn’t come to pass in a big way. I was startled to read that you found some philosophers attempting to reclaim the term “eugenics.” You cite one who wrote a paper called “Defending eugenics,” which sets out to “reclaim the spirit” of eugenicists like Charles Darwin and Francis Galton. You cite another who calls for “liberal eugenics” grounded in the freedom of parents to choose how to enhance their children in accordance with their own values. One Oxford philosopher even says parents have a duty of “procreative beneficence” and should select embryos or fetuses “most likely to have the best life” based on the genetic information they have. That was also surprising to me. Like you, I also thought it was a discredited and taboo word. It’s hard to know how widespread those views are. I mean to be clear, eugenics has always been part of our culture in the US. I think people forget that a lot of Nazi policy was inspired by American eugenic policies, and it’s an attitude that has never really gone away. We still see it in a lot of subtler forms that I mention in the book. I mean, even just how people are choosing embryos and terminating pregnancies based on certain genetic conditions. “Clearly you could have a lot more children being born if these technologies were more accessible.” This eugenicist rhetoric is gaining steam at a moment when some people are also really hard at work on developing technologies that could enable this sort of thing. While some of these philosophers will definitely make a distinction between parents making some individual choices vs. a state sponsored program, I think it’s the attitude that’s at the root of this, and that’s what we really need to work on criticizing and dismantling. So the book is arriving just as Rep. Alexandria Ocasio-Cortez has been documenting her egg freezing journey, and talking about how she wants to push to expand insurance coverage and federal support for fertility treatments. What does her experience — and the reaction to it — say about our current moment? Some on the right were so mad, as if she should just throw in the towel or eschew hope and agency at age 36. What’s so interesting about her experience that I think that people miss is, yes, is it exceptional that she’s contemplating a run for president? Sure. Not many of us are doing that. But on many other levels, she’s doing what a lot of women who can afford to do in their late 30s do when they’re still single. In the book I mention the research of Marcia Inhorn, who interviewed about 150 women who sought to freeze their eggs. And what’s interesting is if you look at their profiles, they were city-dwelling professionals who were on average nearly 37 at the time of freezing. That is AOC to a tee, and if you asked those study participants why they were doing it, most were not doing so because they felt like they needed to put their families on hold to pursue careers. A full 82 percent cited their lack of a partner as the prime motivation. They wanted to have a family at some point and didn’t want to rule that out. What do you think we should take from other countries that do subsidize egg freezing? So the city of Tokyo has subsidized egg freezing and they were totally oversubscribed. So many women took up the city’s offer, and France has also started offering it. More places offer IVF coverage for people who need it because they treat infertility like a disease, which is how the World Health Organization defines it. What’s interesting is when you look at places where there is more coverage, it also gives you a sense of the scale of need for it. So in Denmark, where you can get something like up to six rounds of treatment publicly funded for your first child and another three rounds for your second child; I believe about one in nine children is born there with assisted reproductive technologies. If you compare that with the US, it’s closer to one in 36. So clearly you could have a lot more children being born if these technologies were more accessible. In the book you cite historian Sara Matthiesen, who argues that since legal abortion helped transform having a child into more of a personal choice, pregnancy thus became understood as chosen, with parents then sacrificing or forfeiting some of their claim on societal help. I couldn’t tell where you landed on that argument. Do you find it persuasive? So I find it persuasive in the sense that I feel like conservatives will grab onto any argument to avoid state responsibility towards families and children. The fact that you can terminate a pregnancy is one more reason that can be provided to individualize the responsibility of parenthood. But I think that we’re also seeing the mirror image of that — where the choice to remain or not remain pregnant has also been taken away in so many places post-Roe. And I don’t think that has resulted in the converse of her argument, which is that when that choice is taken away and you can no longer sever pregnancy and motherhood, then states and society will step up to acknowledge that reality. In the middle of your book you recall an ex-boyfriend, who was divorced and felt it would be impossible to afford a second kid. You were surprised by this, and later cite a pregnant woman in Venezuela you met while traveling, who was worried about money but excited about parenthood. She told you the Venezuelan proverb that “a baby comes with a loaf of bread under his arm.” The subtext was that they believe things will work out. The subtitle of your book is The Impossibility of Family in Age of Uncertainty. So where do you land? Is it impossible, as your ex said? I think that’s what people are trying to negotiate with themselves. That’s where things like faith, agency, and disposition come into play. One of the reasons I wanted to write this book was I feel like birth rates and demography are always discussed in terms of these data points that people can measure, like how many people are married and how old are they, and do they have college education or not? Do they earn X, Y, Z income, or not? Do they have a job? But it’s just all so personal. So the Venezuelan woman was an optimist, whether that’s culturally or dispositionally, and she did believe things would be okay. And I think we all know stories of people who’ve grown up who came from very challenging backgrounds and wound up achieving some sort of fame, fortune, success…so we know that things are always possible. And that’s where questions of what one is prepared to sacrifice come into play, or what expectations do you have of what you want to provide a child. The thing I really want to highlight is how individual these negotiations are, whether you come down on it being impossible or whether you want to lower your standards and maybe your child doesn’t get in-home violin lessons or if music’s really important to you and you can’t imagine a universe in which your child doesn’t play an instrument. I cover these issues too and I think about a lot about what our role in the media is. I share your view on reproductive justice, and wanting to help people live the lives they want. But you also wrote about experiencing what you called “money dysmorphia” — when someone is feeling insecure about their financial situation even when they are in fact okay. What role do we have as journalists to help people distinguish between genuine financial impossibility and the fear that they can never be secure enough? And if we don’t do that, how do we not end up in a world where only rich people are encouraged to have kids? So I try to be optimistic, but I also feel like as a country, there’s no bottom to how far someone can fall in America. As Elizabeth Warren found, having a child is a huge predictor of bankruptcy. I would like to be more positive. And I do believe that there’s so many easy policy fixes, so many ways to make parenting easier. But for people I know who’ve gone through serious financial distress because of things in their life changing, there’s a limit to what I can do or say without giving them all my resources. Regardless of our job as media, I wish I could say that everything will work out fine. And in some cases it can. Again, people do really great jobs being parents with so much less than I have, which is something I try to keep in mind all the time. But I also would say as a society that we let people fall all the way through the floor and then some. We just don’t have a safety net. So I find it hard to say that everything will work out and you’ll wind up fine. At the beginning of your book you talk about how having children is an intensely personal decision and you’re not interested in writing about if it’s “good” or “bad” or “worth it.” One of the critiques conservatives make about people like us is that we can be so averse to making any kind of normative statement about having kids that we’ve lost the plot. I’m curious for your thoughts on that. In a book arguing that we need more family-friendly policies, do you think you need to more explicitly say that having kids is a good thing to do? What I would say is loving relationships are good, and having kids is one of those. I think parenthood is an exceptional one just in the level of responsibility that you’re inviting. Having kids for people who want to have kids is good. But I don’t know, I do hesitate to privilege that relationship above all others because of what doing so means. If you say having kids is good, well, who has kids? That immediately has gendered implications and instantly puts an onus on women. Though we say public libraries are good and that doesn’t mean we have to make libraries against people’s will. But yeah, I guess I wonder if that avoids the ways this kind of relationship is different from other loving relationships. While this isn’t my argument or what personally motivates me, I think one can definitely make a case that having kids is more of a social good than some other kinds of relationships. I think when we say society should be more family-friendly and fund it with tax dollars, it’s not just so everyone can live out the lives they want, but also so we can support our society now and in the future. Lyman Stone I think gets at this, he says children are good because people are good. Again, I would say if you feel like you might be a good parent and enjoy that relationship, that specific relationship, the whole point of my book is I want that to be more accessible because from what I’ve seen and now in my own experience, it is an amazing relationship. It’s not a relationship like any other one I’ve ever had. But I guess it’s not clear to me what the corollary is of saying having kids is good. It’s definitely good for people who want to have kids, but it’s definitely not good for people who don’t want to have kids. But I’m not someone who always wanted to have kids myself. And while I’m strongly against coercing people into having children, I think there are millions of people like me who are like, “I don’t know. I’m not sure. I can’t really picture it.” There are people on the right who say, “Therefore, just do it because you’ll like it” And I don’t think that’s appropriate. But it’s also true that for most of human history, people were simply not asked to come down on this question of: “Do I want it or not?” Now today I’m so glad I had a child, but if you had asked me five years ago I would have said, “I don’t really like little kids. It’s never been my thing.” So the identity question becomes interesting and confusing to me, and I think it leaves me more uncomfortable with the idea that we should just support whatever anyone’s choice or desire is today when we know that our choices and desires do change, including based on what people absorb in the media. I think a lot of young people are just really struggling. I see this all the time on Reddit threads or listening to young people talk about their lives who say, “If I can barely take care of myself, how can I take care of someone else?” We don’t have a society that makes any form of caregiving easy, and people are really struggling to find work. We have a society that doesn’t make it easy to care for oneself, for one’s parents, for one’s friends, for one’s partner. I mean I did have a kid before I felt totally comfortable and I was just really fortunate that it worked out. I do agree with some of the people on the right who say that a lot of the things you think you need to become a parent, you don’t. And we know that really great people grow up all over the world where they have much fewer resources and infrastructure and everything. So I do think kids need a lot less than we often imagine they need. And that is part of thinking about your own expectations and what you want for a child and also, again, what you’re prepared to sacrifice. I joke that I go to an annual yoga class fairly regularly. I don’t really cook anymore. I had a single mom who was just resourceful, though she was lucky to be in New York City, where there actually are resources to access. If you’re living in Tennessee or Mississippi those types of resources would probably not be available.